In Berlin today for a Global Business Coalition on HIV/AIDS
meeting, US Global AIDS Coordinator Randall Tobias dismissed criticisms
that President Bush's $15 billion AIDS initiative has an unrealistic
focus on abstinence. Encouraging monogamy and delayed sexual activity
among teens are far more productive than focusing on condom use, Tobias
said. "Statistics show that condoms really have not been very
effective," Tobias told a news conference at the US embassy in Berlin,
referring to condom distribution in Africa. "It's been the principal
prevention device for the last 20 years, and I think one needs only to
look at what's happening with the infection rates in the world to
recognize that has not been working."

The American coordinator of the fight against the AIDS estimates that
it is more effective to encourage sexual abstinence for
teenagers than to promote the use of condoms.

Encouraging sexual abstinence for teenagers is more effective in
the combat against the HIV virus than to promote the use of the
condoms, said the coordinator American of the fight
against the AIDS, Randall Tobias, on Thursday at a visit in Berlin.
"The statistics show that the condoms were really not very effective,"
Randall Tobias said during a press conference at the U.S. embassy
in Berlin, the day before departing to visit sub-Saharan Africa.
"The condom was the heart of prevention campaigns these last twenty
years, and I believe that one has right need to throw a glance on
the rates of contamination in the world to note that they did not go."
The United States launched a five-year program in the fight against
AIDS for an amount of 15 billion dollars, which consists inter alia
encouraging teenagers with sexual abstinence before
marriage, causing an outcry among the nongovernmental organizations.

The Ugandan example

Randall Tobias explained why the American initiative was based on an
Ugandan program centered on the encouragement of the abstinence in the
young people, the monogamy at the couples and the use of condoms for
the prostitutes and their customers.

"The Ugandan model had results proving that it was the best approach in
prevention," affirmed the American coordinator who took part in Berlin
with an international conference of the sector deprived on AIDS.
More than any other continent, Africa is touched by the HIV virus,
with between 20% and 40% of the contaminated adults, according to the
agency of the United Nations for AIDS, UNAIDS.

"Here to talk to us about women's rights around the world is Kavita
Ramdas. She is president and CEO of the non-profit organization the
Global Fund for Women, which gives grants to poor and disadvantaged
women in 160 countries."

[excerpted segment of transcript]

BRANCACCIO [the Host]: I want to ask you about a Bush Administration
policy priority. There is an emphasis on abstinence as an approach to,
for instance, the AIDS crisis. And a de-emphasis, for instance, on the
use of condoms as an approach to this. How do you parse that situation?

RAMDAS: Well, I love to use the Ugandan example that President Bush
likes to quote. But I like to tell it because the Global Fund has the
experience of working with 46 different women's organization inside
Uganda. Uganda's famous ABC campaign.

BRANCACCIO: A is for abstinence.

RAMDAS: Abstain. B is for be faithful. And C is for condoms.

BRANCACCIO: So ABC approach.

RAMDAS: The ABC approach.

BRANCACCIO: Now, in the Ugandan example I was hearing a quote just this
week from President Bush's anti-AIDS czar. And he was saying that
condoms, quote, "really have not been very effective in this fight"
against this scourge.

RAMDAS: So, let me share with you the stories from the Ugandan women's
groups. The ABC campaign in Uganda was used as a collective mobilizing
tool by women's organization across Uganda. And they didn't use
abstinence in this sort of puritanical or even moralistic sense. They
used abstinence much more like the play LYSISTRATA.

BRANCACCIO: LYSISTRATA, the Greek drama in which what happened with
the women?

RAMDAS: Women succeeded in abstaining and, therefore, getting their
husbands to end the war. In the Ugandan case, infidelity and the fact
that men have multiple sexual partners and were, therefore, infecting
wives often without their knowledge.

BRANCACCIO: And I read that the rate of AIDS infection is particularly
high among married women in Africa.

RAMDAS: Absolutely. But also in other countries. India right now has a
significant increase in married women rates of HIV. But the Ugandan
women use the ABC model that President Bush likes to quote as an
incredibly effective organizing tool. It was not used in the sense of
sort of Christian abstaining from the pleasures from sex.

But, rather, entire groups of women in villages would get together and
talk to their husbands and say, "All of us, collectively, none of us
are going to be having sex with you. Not tonight. Not tomorrow night.
Not for 15 nights." And this was then combined with a sex education
program that was remarkable.

It involved adolescent girls, young men, husbands, grandfathers,
uncles. Brought them in to talk about sex, power and changes in sexual
behavior. That has brought the incidence of HIV-AIDS infection in
Uganda down to six percent today.

BRANCACCIO: It was extraordinarily higher.

RAMDAS: It was close to 20 percent of in 1988, it was close to 20
percent. So, yes, abstinence can certainly be used as a tool. But I
think it was not being used as a way of saying, "We will not have sex."
What the women then used it to do was to say, "We will have sex with
you if you use a condom. We will have sex with you if you use a condom
and stop fooling around."

And I think those are examples of us being able to consider how you
need a multi-prong strategy. And women certainly understand that very,
very in a very direct and non-academic way. And that's how the women
of Uganda, supported by their government, were, I think, as successful
as they have been.

A young speaker decried HIV/AIDS prevention campaigns that moralised, which they said were particularly unreflective of young womens sexual options. The push for ABC is an example of one generations dishonest morality being visited on another... The key to prevention lies in giving us options, not ideologies We need to be accepted for our choices, not despite them  anything else will just fuel this epidemic.

The inadequacy of ABC enforcement was echoed by Professor Dennis Altman, politics professor at La Trobe University in Australia. Professor Altman challenged the appropriateness of rigid ABC prevention messages. What meaning is there, he asked, in asking the young boy living on the street, to not indulge in drugs to momentarily escape the cold and loneliness?

Another podium speaker, Dr Thoriah Obaid, executive director of the UN Population Fund, agreed. With a unified voice, the world must tell young people that you are old enough to know about sexuality, and you are too young to die.

Strong condemnation of prevention teaching guidelines for developing nation schools came from Dr Mary Crewe of the Centre for the Study of AIDS at Pretoria University, South Africa. If prevention was just so easy, educators would have employed these methods years ago, she said.

She described the US governments prevention teaching guidelines for developing nation schools, released under the Presidents Emergency Plan for AIDS Relief (PEPFAR), as being paternalistic, patronising and prescriptive informed by a dogma that blinds people to the realities of the modern world.

She advocated a radical overhaul of awareness education, so that this epidemic might transform whole school systems for the better We can use AIDS education to bring back social integrity, gender equality and compassion. Many would agree.